Analytical, Diagnostic and Therapeutic Techniques and Equipment Commons^™

Blood Pressure Monitoring Of Hypertensive Patients In Primary Care: Barriers And Facilitators To Ambulatory, Office, And Home Blood Pressure Monitoring In The Context Of The Triple Aim, Elizabeth Andrews

Muskie School Capstones and Dissertations

Hypertension represents a population health issue in that many patients are misdiagnosed and over-or-under medicated. Research has indicated that overestimating the true blood pressure by 5 mmHg leads to over 30 million Americans being inappropriately treated with blood pressure medication (Handler, 2009). Blood pressure measurements taken in the office are often inaccurate due to patient behaviors, improper technique, and observer errors, yet providers are still using this method to diagnose hypertension. Therefore, considering other methods of blood pressure for the diagnosis and management of hypertension is important to the healthcare quality for millions of Americans.

The main objective of this …

Defining Obesity: An Argument For The Social Environment Perspective, Meghan Mcinnis

Annual Undergraduate Conference on Health and Society

It is well documented that obesity is a growing problem in the U.S. and worldwide. By 2010, 35.9% of U.S. adults age 20 and older were obese (Overweight and Obesity, CDC). Obesity has been associated with many health problems, including hypertension, type 2 diabetes, osteoarthritis, stroke, and cardiac disease (Lucey, 2008, p.202). What has just been described is the traditional, medicalized narrative of obesity. In this narrative, obesity is viewed as an epidemic that demands an immediate and widespread response (Lucey, 2008, p.202). The blame is placed largely on individuals, while social factors, such as socioeconomic status and neighborhood environment, …

Refining Best Practices For The Diagnosis Of Autism: A Comparison Between Individual Healthcare Practitioner Diagnosis And Transdisciplinary Assessment., Jessica Rae Stewart, Debra C. Vigil, Erika Ryst, Wei Yang

Nevada Journal of Public Health

The purpose of this study is to compare the diagnostic decision-making of individual healthcare practitioners against that of a transdisciplinary team. Despite national recognition of transdisciplinary assessment as the gold standard diagnostic approach, autism is most frequently diagnosed by individuals working independently in a variety of disciplines. The current study examined how closely these individual practitioners make diagnoses matching that of a transdisciplinary team. Twenty professionals from five different disciplines viewed videotape clips of fifteen children previously assessed by a transdisciplinary team. Results confirmed that individual healthcare practitioners matched the transdisciplinary team diagnosis on average only 65.6% of the time. …

Medial Tibial Stress Syndrome, Jacqueline Knowles

Thinking Matters Symposium Archive

The purpose of this project is to examine an exercise-­‐based approach to rehabilitating an athlete with medial tibial stress syndrome. It presents specific exercises that can be used, and focuses on resolving the core of the problem instead of just addressing the symptom. This review attempts to provide a long-­‐term solution rather than providing a quick fix.

"Wiser And Wider": An Analysis Of Dsd Treatment Protocol In The Netherlands And Practitioner And Patient Attitudes Towards Medical Care, Mel Ferrara

Independent Study Project (ISP) Collection

The main objective of this study is to assess current medical practices in the Netherlands for the treatment of disorders of sexual development (DSD) through interviews with both medical practitioners and individuals diagnosed with these conditions. Data was obtained qualitatively through personal interviews with a pediatric endocrinologist, pediatric urologist, ethicist, and four men who have been diagnosed with Klinefelter's Syndrome. This study examines how institutional protocol aligns with individual practitioner's perception of ideal treatment as well as their own conceptions of sex and gender. This data is juxtaposed with the personal experiences and perspectives of several men diagnosed with Klinefelter's …

Estimating Child Sleep From Parent Report Of Time In Bed: Development And Evaluation Of Adjustment Approaches, Timothy D. Nelson, Alyssa Lundahl, Dennis L. Molfese, Rachel N. Waford, Adrienne Roman, David Gozal, Victoria J. Molfese, Melissa C. Ferguson

Department of Psychology: Faculty Publications

Objective To develop and evaluate adjustment factors to convert parent-reported time in bed to an estimate of child sleep time consistent with objective measurement. Methods A community sample of 217 children aged 4–9 years (mean age = 6.6 years) wore actigraph wristwatches to objectively measure sleep for 7 days while parents completed reports of child sleep each night. After examining the moderators of the discrepancy between parent reports and actigraphy, 3 adjustment factors were evaluated. Results Parent report of child sleep overestimated nightly sleep duration by ~24 min per night relative to actigraphy. Child age, gender, and sleep quality all …

Comparison Of Functional Network Connectivity For Passive-Listening And Active-Response Narrative Comprehension In Adolescents, Yingying Wang, Scott K. Holland

Center for Brain, Biology, and Behavior: Faculty Publications

Comprehension of narrative stories plays an important role in the development of language skills. In this study, we compared brain activity elicited by a passive-listening version and an active-response (AR) version of a narrative comprehension task by using independent component (IC) analysis on functional magnetic resonance imaging data from 21 adolescents (ages 14–18 years). Furthermore, we explored differences in functional network connectivity engaged by two versions of the task and investigated the relationship between the online response time and the strength of connectivity between each pair of ICs. Despite similar brain region involvements in auditory, temporoparietal, and frontoparietal language networks …

Variability Of M-Mode Versus Two-Dimensional Echocardiography Measurements In Children With Dilated Cardiomyopathy., Caroline K. Lee, Renee Margossian, Lynn A. Sleeper, Charles E. Canter, Shan Chen, Lloyd Y. Tani, Girish S. Shirali, Anita Szwast, Elif Seda Selamet Tierney, M Jay Campbell, Fraser Golding, Yanli Wang, Karen Altmann, Steven D. Colan, Pediatric Heart Network Investigators

Manuscripts, Articles, Book Chapters and Other Papers

M-mode and 2-dimensional (2D) echocardiographic imaging are routinely used to quantify left-ventricular (LV) size and function in pediatric patients with dilated cardiomyopathy (DCM). The reproducibility of and correlation between these techniques are unknown. This analysis sought to compare interreader, intrareader, and interacquisition reproducibility of M-mode versus 2D measurements in pediatric DCM patients. The Ventricular Volume Variability study of the Pediatric Heart Network is a multicenter, prospective, observational study assessing the course of chronic DCM in children. Two sonographers performed baseline image acquisitions locally, and two readers performed measurements at the echocardiographic core laboratory. One reader repeated measurements 1 month later. …

Improved Protocols For Vibrational Spectroscopic Analysis Of Body Fluids, Franck Bonnier, François Petitjean, Matthew Baker, Hugh Byrne

Articles

The applications of vibrational spectroscopy to the examination of human blood serum are explored. Although FTIR spectra can be recorded in aqueous solutions at (gelatin) concentrations as low as 100mg/L, the high-wavenumber region remains obscured by water absorption. Using Raman spectroscopy, high quality spectra of gelatine solutions as low as 10mg/L can be achieved, also covering the high-wavenumber regions. In human serum, spectral profiles are weak and partially obscured by water features. Dried deposits are shown to be physically and chemically inhomogeneous resulting in reduced measurement reproducibility. Concentration of the serum using commercially available centrifugal filter devices results in an …

Introducing And Evaluating 3d Digital Breast Tomosynthesis, Marie Hrinkonich, Susan Steigerwalt

Department of Radiology & Diagnostic Medical Imaging

No abstract provided.

Cone Beam Computertomography (Cbct) In Interventional Chest Medicine – High Feasibility For Endobronchial Real Time Navigation, Wolfgang Hohenforst-Schmidt, Paul Zarogoulidis, Thomas Vogl, J. Francis Turner, Robert Browning, Bernd Linsmeier, Haidong Huang, Qiang Li, Kaid Darwiche, Lutz Freitag, Michael Simoff, Ioannis Kioumis, Konstantinos Zarogoulidis, Johannes Brachmann

Internal Medicine Faculty Publications

Introduction: Currently there are several advanced guiding techniques for pathoanatomical diagnosis of incidental solitary pulmonary nodules (iSPN): Electromagnetic navigation (EMN) with or without endobronchial ultrasound (EBUS) with miniprobe, transthoracic ultrasound (TTUS) for needle approach to the pleural wall and adjacent lung and computed tomography (CT)-guidance for (seldom if ever used) endobronchial or (common) transthoracical approach. In several situations one technique is not enough for efficient diagnosis, therefore we investigated a new diagnostic technique of endobronchial guided biopsies by a Cone Beam Computertomography (CBCT) called DynaCT (SIEMENS AG Forchheim, Germany). Method and Material: In our study 33 incidental solitary pulmonary nodules …

Molecular Pap Biomarkers For Cervical Cancer Risk Assessment In Thinprep® Clinical Specimens, Jennifer Taylor

Graduate School of Biomedical Sciences Theses and Dissertations

Approximately 500,000 patients are diagnosed with cervical cancer worldwide each year, thus making it the second most common cause of cancer-related deaths in women. Persistent high-risk human papillomavirus (HR-HPV) infections induce cervical dysplasia by increasing the expression of two viral oncogenes, E6 and E7. Utilization of the Papanicolaous smear test (Pap test) has contributed to a decrease in morbidity and mortality of cervical cancer; however, subjective analysis of cell morphology with a limited amount of cells has led to a substantial rate of false positive and false negative diagnoses. A more objective and sensitive diagnostic tool for the detection of …

A Rehabilitation Program For Lung Cancer Patients During Postthoracotomy Chemotherapy, Amy J. Hoffman, Ruth Ann Britnall, Alexander Von Eye, Lee W. Jones, Gordon Alderink, Lawrence H. Patzelt, Jean K. Brown

Peer Reviewed Articles

Objective: The objective of this pilot study was to describe the effects of a 16-week home-based rehabilitative exercise program on cancer-related fatigue (CRF), other symptoms, functional status, and quality of life (QOL) for patients with non-small cell lung cancer (NSCLC) after thoracotomy starting within days after hospital discharge and continuing through the initiation and completion of chemotherapy.

Materials and methods: Five patients with NSCLC completed the Brief Fatigue Inventory (measuring CRF severity) and the MD Anderson Symptom Inventory (measuring symptom severity) before and after thoractomy, and at the end of each week of the 16-week exercise program. Additionally, the Medical …

Radiation Exposure Of Patients By Cone Beam Ct During Endobronchial Navigation - A Phantom Study, Wolfgang Hohenforst-Schmidt, Rosemarie Banckwitz, Paul Zarogoulidis, Thomas Vogl, Kaid Darwiche, Eugene Goldberg, Haidong Huang, Michael Simoff, Qiang Li, Robert Browning, Lutz Freitag, J. Francis Turner, Patrick Le Pivert, Lonny Yarmus, Konstantinos Zarogoulidis, Johannes Brachmann

Internal Medicine Faculty Publications

Rationale: Cone Beam Computed Tomography imaging has become increasingly important in many fields of interventional therapies. Objective: Lung navigation study which is an uncommon soft tissue approach. Methods: As no effective organ radiation dose levels were available for this kind of Cone Beam Computed Tomography application we simulated in our DynaCT (Siemens AG, Forchheim, Germany) suite 2 measurements including 3D acquisition and again for 3D acquisition and 4 endobronchial navigation maneuvers under fluoroscopy towards a nodule after the 8th segmentation in the right upper lobe over a total period of 20 minutes (min). These figures reflect the average complexity and …

Vaccine-Preventable Diseases In Travelers, Edith Mirzaian, Jeffery A. Goad, Ani Amloian, Fady Makar

Pharmacy Faculty Articles and Research

Travel to the developing world is increasing among those from developed countries, placing them at risk for vaccine preventable and non-vaccine preventable diseases. From 2007-2011, the GeoSentinel Network reported 737 returned travelers with a vaccine preventable disease. While it is essential that clinicians use vaccines when available for a disease of risk, they should also be aware that the vast majority of diseases acquired by travelers are non-vaccine preventable. The vaccine preventable diseases can be divided into routine travel vaccines, special travel vaccines and routine vaccines used for travel. The routine travel vaccines include Hepatitis A and B, typhoid; special …

Variation In Feeding Practices Following The Norwood Procedure., Linda M. Lambert, Nancy A. Pike, Barbara Medoff-Cooper, Victor Zak, Victoria L. Pemberton, Lisa Young-Borkowski, Martha L. Clabby, Kathryn N. Nelson, Richard G. Ohye, Bethany Trainor, Karen Uzark, Nancy Rudd, Louise Bannister, Rosalind Korsin, David S. Cooper, Christian Pizarro, Sinai C. Zyblewski, Bronwyn H. Bartle, Richard V. Williams, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

OBJECTIVES: To assess variation in feeding practice at hospital discharge after the Norwood procedure, factors associated with tube feeding, and associations among site, feeding mode, and growth before stage II.

STUDY DESIGN: From May 2005 to July 2008, 555 subjects from 15 centers were enrolled in the Pediatric Heart Network Single Ventricle Reconstruction Trial; 432 survivors with feeding data at hospital discharge after the Norwood procedure were analyzed.

RESULTS: Demographic and clinical variables were compared among 4 feeding modes: oral only (n = 140), oral/tube (n = 195), nasogastric tube (N-tube) only (n = 40), and gastrostomy tube (G-tube) only …

Utilizing Fast Spin Echo Mri To Reduce Image Artifacts And Improve Implant/Tissue Interface Detection In Refractory Parkinson’S Patients With Deep Brain Stimulators, Subhendra N. Sarkar, Pooja R. Sarkar, Efstathios Papavassiliou, Rafael Rojas

Publications and Research

Introduction. In medically refractory Parkinson’s disease (PD) deep-brain stimulation (DBS) is an effective therapeutic tool. Postimplantation MRI is important in assessing tissue damage and DBS lead placement accuracy. We wanted to identify which MRI sequence can detectDBS leads with smallest artifactual signal void, allowing better tissue/electrode edge conspicuity.

Methods. Using an IRB approved protocol 8 advanced PDpatientswere imagedwithinMRconditional safety guidelines at lowRF power (SAR ≤ 0.1 W/kg) in coronal plane at 1.5T by various sequences.The image slices were subjectively evaluated for diagnostic quality and the lead contact diameters were compared to identify a sequence least affected by metallic leads.

Results …

Heart Attack And Kidney Attack: Evolution Of Lay And Clinical Terms For Spontaneous, Acute Organ Injury Syndromes, Claudio Ronco, Peter A. Mccullough, Pupulan Iyngkaran, Lakhmir S. Chawla

Anesthesiology and Critical Care Medicine Faculty Publications

No abstract provided.

Detection Of Homocysteine With Bridged Viologen Chemical Probes, Davin Rautiola

Dissertations and Theses

Increased blood plasma concentrations of the aminothiol homocysteine (Hcy) are associated with a variety of disease states including those which cause impaired renal function, many forms of cardiovascular disease, and neurodegenerative diseases such as Alzheimer's. Therefore, Hcy has the potential to be a significant diagnostic biomarker. Routine monitoring of Hcy plasma concentration is encumbered by the time and resources required to quantify Hcy using currently accepted instrumental analysis methods. As part of the continuing effort to develop a quick, reliable, inexpensive, and user-friendly test to quantify Hcy at the point of care, we have designed a series of novel colorimetric …

Renal Recovery, Stuart L. Goldstein, Lakhmir S. Chawla, Claudio Ronco, John A. Kellum

Anesthesiology and Critical Care Medicine Faculty Publications

Acute kidney injury (AKI) research in the past decade has mostly focused upon development of a standard AKI definition, validation of early novel biomarkers to predict AKI prior to serum creatinine rise and predict AKI severity, and assessment of aspects of renal replacement therapies and their impact on survival. Given the independent association between AKI and mortality in the acute phase, such focus makes imminent sense. More recently, the recognition that AKI is associated with subsequent development of chronic kidney disease and end-stage renal disease, with the attendant increase in mortality, has led to interest in the clinical epidemiology and …

The Importance Of Managing Psychosocial Health: A Case Study, Mary Insana Fisher, Harold L. Merriman

Physical Therapy Faculty Publications

Managing the physical aspects of lymphedema requires an individual to be committed to daily treatment of this chronic condition. Performing manual lymph drainage, using compression bandaging or compression garments, exercising, and caring for the skin all take time and a high level of dedication. This commitment to self-care can be emotionally and psychologically exhausting.

When coupled with other emotional stressors in a patient’s life, successful treatment of lymphedema is challenging. We present a case demonstrating how the physical and psychological aspects of care interplay, and, when well-managed, can positively affect the outcome.

Breast Cancer Edge Task Force Outcomes - Clinical Measures Of Strength And Muscular Endurance: A Systematic Review, Mary Insana Fisher, Claire Davies, Christine Beuthin, Genevieve Colon, Brittany Zoll, Lucinda Pfalzer

Physical Therapy Faculty Publications

Background: Muscular strength deficits are a common morbidity following treatment for breast cancer. Accurate assessment of strength and muscular endurance following breast cancer treatments is essential in identifying deficits and planning rehabilitation strategies.

Purpose: The purpose of this systematic review was to identify strength and muscular endurance outcome measures for use with women treated for breast cancer that possess strong psychometric properties and are clinically useful.

Methods: Multiple electronic databases were searched between February and June 2013. Included studies of tools used to assess strength and muscular endurance met the following criteria: reported psychometric properties, clinically feasible methods, adults (preferably …

Test Items In The Complete And Short Forms Of The Bot-2 That Contribute Substantially To Motor Performance Assessments In Typically Developing Children 6-10 Years Of Age, Kadi Carmosino, Ashley Grzeszczak, Kaylie Mcmurray, Ali Olivo, Bo Slutz, Brittany Zoll, Betsy Donahoe-Fillmore, C. Jayne Brahler

Physical Therapy Faculty Publications

Objectives: Determine the magnitude of association between individual subtest items of the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), and the respective total subtest scores and to review items on the BOT-2 Short Form.

Background: The Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2), is a test used to measure gross motor proficiency in both typically developing children and children with developmental disabilities between the ages of four and twenty-one. The BOT-2 Short Form consists of fourteen test items proportionally selected from the subtests of the Complete Form. It can be used as a screening tool and takes less …

Ethical Dilemmas Posed In The Care Of Obese Patients In The Emergency Department, Arvind Venkat, Gregory Luke Larkin

Journal of Health Ethics

The rising prevalence of obesity represents a health care crisis. As the gateway to the health care system, the emergency department is the clinical setting where the difficulties posed by the care of obese patients are heightened. These difficulties include the increasing burden of obesity-related illnesses, the challenges posed in diagnostic evaluation and treatment and the known barriers to access to care seen in this patient population. The limitations posed by obesity on care in the emergency department, the one guaranteed access point for medical treatment, creates a series of ethical dilemmas for emergency physicians and the facilities in which …

International Clinical Rotations During U.S. Residency Training: Creating An Accreditation Council For Graduate Medical Education-Approved Rotation, Jeffrey S. Berger, Deborah Jeon, Eric P. Chiang, Daniel Asay, Huda M. Ayas

Anesthesiology and Critical Care Medicine Faculty Publications

Healthcare professionals increasingly report interest in global health and participation in international healthcare delivery. Growth opportunities exist for trainees to improve knowledge, skills and attitudes through international experiences. Professional development via international medicine may have lasting effects on patient care and practice patterns following training. In 2010, the first resident took part in an international, exchange elective between The George Washington University’s Department of Anesthesiology in Washington, DC and La Universidad de San Francisco’s Department of Anesthesiology in Quito, Ecuador. This resident elective rotation resulted from a strategic partnership, initiated in 2008, between two training institutions with an established track …

A Qualitative Study Of Rural Primary Care Clinician Views On Remote Monitoring Technologies, Melinda M. Davis, Jillian M. Currey, Sonya Howk, Molly R. Desordi, Linda Boise, Lyle J. Fagnan, Nancy Vuckovic

Community Health Faculty Publications and Presentations

Purpose: Remote monitoring technologies (RMTs) may improve the quality of care, reduce access barriers, and help control medical costs. Despite the role of primary care clinicians as potential key users of RMTs, few studies explore their views. This study explores rural primary care clinician interest and the resources necessary to incorporate RMTs into routine practice.

Methods: We conducted 15 in-depth interviews with rural primary care clinician members of the Oregon Rural Practice-based Research Network (ORPRN) from November 2011 to April 2012. Our multidisciplinary team used thematic analysis to identify emergent themes and a cross-case comparative analysis to explore variation by …

In Vitro Propagation Of Gentiana Scabra Bunge – An Important Medicinal Plant In The Chinese System Of Medicines, Shih-Hung Huang, Dinesh Chandra Agrawal, Fang-Sheng Wu, Hsin-Sheng Tsay

Biology Publications

Background: Gentiana scabra Bunge commonly known as `Long dan cao' in China has been used in traditional Chinese medicines for more than 2000 years. Dry roots and rhizome of the herb have been used for the treatment of inflammation, anorexia, indigestion and gastric infections. Iridoids and secoiridoids are the main bioactive compounds which attribute to the pharmacological properties of this plant. The species is difficult to mass propagate by seed due to the low percentage of germination and limited dormancy period. Wild populations in some locations are considered to be in the endangered category due to over exploitation.

Results: In …

The Search For Novel Inhibitors Of The Mycobacterial Enoyl Reductase Inha, Esther Saul

The Science Journal of the Lander College of Arts and Sciences

Isoniazid (INH), one of two first-line drugs used to treat tuberculosis (TB), has been shown to be a potent inhibitor of InhA, the mycobacterial enoyl reductase. However, the increasing resistance to INH makes it imperative to find alternative drugs that are as effective as the first-line drugs, yet active against INH-resistant strains. Since InhA has been validated as an excellent target of TB, there have been attempts to find novel inhibitors of InhA. Through rational drug design, a variety of high affinity InhA inhibitors were synthesized. Triclosan itself was observed to be a suboptimal inhibitor of InhA with a K …

Vibrational Spectroscopy: Disease Diagnostics And Beyond, Hugh Byrne, Kamila Ostrowska, Haq Nawaz, Jennifer Dorney, Aidan Meade, Franck Bonnier, Fiona Lyng

Books/Book Chapters

Summary

This chapter outlines some developments in the applications of vibrational spectroscopy for disease diagnostics and demonstrates how the applications of the spectroscopic techniques can be extended to the analysis and evaluation of disease aetiology and the mechanisms of interaction and the cellular and subcellular responses to, for example chemotherapeutic agents and nanoparticles. The primary emphasis is on Raman spectroscopy, although some examples are based on infrared absorption spectroscopy. The studies presented are chosen to illustrate how a range of multivariate analytical techniques can be employed to maximize the potential benefits of the complex spectral information obtained from tissue or …

The Helminthological Society Of Washington 2013 Anniversary Award: Larry S. Roberts, Sherman S. Hendrix

Center for Brain, Biology, and Behavior: Faculty Publications

Dr. Roberts was born in the great state of Texas, and much of his early life is murky, but snakes are often mentioned. Larry received his Bachelor’s degree at Southern Methodist University; his Master of Science at the University of Illinois; and his Doctorate in the Department of Pathobiology at the Johns Hopkins School of Hygiene and Public Health. Larry’s doctoral research, published in Experimental Parasitology, documented the early development and crowding effect of the tapeworm, Hymenolepis diminuta, in the rat small intestine. His publication on this subject opened the door to the golden age of cestode physiology and biochemistry …